Individual
MS. CARMELLA RENAE STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1575 W SOUTHERN AVE, APACHE JUNCTION, AZ 85220-7456
(480) 982-1110
(480) 474-8370
Mailing address
5735 E MCDOWELL RD LOT 343, MESA, AZ 85215-1448
(480) 830-7530
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP033913
AZ
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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